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24-Month Interview (PB, EH, TT-HI, TT-LI, PBS)
Provider-Based Sampling Feasibility Study for the Vanguard (Pilot) Study and Data Collection Updates for the National Children's Study (NICHD)
OMB: 0925-0593
IC ID: 193579
OMB.report
HHS/NIH
OMB 0925-0593
ICR 201211-0925-001
IC 193579
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0593 can be found here:
2014-07-25 - No material or nonsubstantive change to a currently approved collection
2014-01-13 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 24.3
24-Month Interview (PB, EH, TT-HI, TT-LI, PBS)
Form and Instruction
24.1 Survey
24 MO Interview 20120413.docx
Form and Instruction
24.2 Survey
Modified Checklist for Autism in Toddlers SAQ 20120413.docx
Form and Instruction
24.3 Survey - Placeholder for copyrighted material
24 MO ASQ-3.docx
Form and Instruction
24.4 Survey - Placeholder for copyrighted material
27 MO ASQ-3.docx
Form and Instruction
24.5 Survey - Placeholder for copyrighted material
30 MO ASQ-3.docx
Form and Instruction
Note to File - 24 Month -- Administration of Ages and Stages 3 Questionnaire.docx
Note to File - 24-Month ASQ Administration
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
24-Month Interview (PB, EH, TT-HI, TT-LI, PBS)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
24.3
Survey - Placeholder for copyrighted material
24 MO ASQ-3.docx
Yes
Yes
Paper Only
Form and Instruction
24.4
Survey - Placeholder for copyrighted material
27 MO ASQ-3.docx
Yes
Yes
Paper Only
Form and Instruction
24.5
Survey - Placeholder for copyrighted material
30 MO ASQ-3.docx
Yes
Yes
Paper Only
Form and Instruction
24.1
Survey
24 MO Interview 20120413.docx
Yes
Yes
Paper Only
Form and Instruction
24.2
Survey
Modified Checklist for Autism in Toddlers SAQ 20120413.docx
Yes
Yes
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Science and Innovation
Subfunction:
Scientific and Technological Research and Innovation
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,251
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,251
0
0
0
0
1,251
Annual IC Time Burden (Hours)
730
0
0
0
0
730
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Note to File - 24-Month ASQ Administration
Note to File - 24 Month -- Administration of Ages and Stages 3 Questionnaire.docx
04/16/2012
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.